Altis, Mikaela Ann

Altis, Mikaela Ann is an sole proprietor health care provider with primary practice located at 315 W Gary Blvd , Clinton OK 73601-2835. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Altis, Mikaela Ann can be contacted via phone (580) 547-0900.

Contact Information

Primary practice address
315 W Gary Blvd Clinton OK 73601-2835
Phone: (580) 547-0900
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X

Profile Details

NPI number 1366053241
LBN Legal business name Altis, Mikaela Ann
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 13th, 2020
Last updated Sep 23rd, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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